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Treating Male Suicide & Depression
Male Suicide & Depression  continuing education addiction counselor CEUs

Section 6

CEU Question 6 | CE Test | Table of Contents | Depression
Social Worker CEUs, Counselor CEUs, Psychologist CEs, MFT CEUs, Nurse CEUs

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In the last track, we discussed self-empathy. However, one of the toughest barriers for men to overcome is breaking down the wall of creating relationships with other men.

It might be noted gay men are six times more likely to attempt suicide than their straight counterparts, and the numbers increase exponentially during the holidays. A Department of Health study indicates that gay youth are up to six times more likely to attempt suicide than straight teens, and gay teenagers account for up to 30 percent of all teenage suicides in the nation.

As you know, our society encourages"men's talk," which I define as stereotypical, emotionless conversation between males. Often, this men's talk means men are poking fun at one another, like verbal bantering found in a locker room. Men who are more expressive may appear feminine. This femininity is a taboo in our homophobic society. As you know, traditional masculinity leaves no room for feminine traits. And what could be more feminine, our society tells us, than loving a man? Cliff, who we discussed in the previous track, is a good example of homophobia and fear of femininity.

Technique: Three Ways to Express Yourself
If you recall, I treated Cliff, a 40-year-old electrician, who stated he had intense feelings of anger with his crew on the job. I told Cliff, "Think about examining yourself from the point of view of Three Ways to Express Yourself.
1. The first way is through verbal sharing of emotions to someone else.
2. The second way you express yourself is through bodily manifestations, like high blood pressure or your weight problem.
3. The third way you can express yourself is unconsciously through disturbed behavior such as yelling at your crew or avoiding communicating with them." Cliff was clearly expressing his emotions the third way, through bouts of anger and yelling.

Cliff decided it was a good idea for him to try to express himself more. However, since he had no female relationships in his life beyond casual conversation with the check-out clerk at the grocery store, he would "open up" to one of his buddies. Cliff was at a neighborhood cook-out, talking to Barry, one of his male neighbors. He started talking about his job. Cliff expressed to Barry how he had felt uneasy at work lately and how he wasn't sure his job was right for him.

As Cliff talked, Barry appeared to be listening. However, when Cliff finished his emotional ranting, Barry walked away, calling out over his shoulder, "How about another hamburger?" Cliff told me that he felt stupid, and that he suddenly felt ashamed and embarrassed. Cliff was also puzzled as to why he was rejected by Barry.

I explained to Cliff that he had perhaps violated gender roles, and it was clear that his friend Barry had sensed this violation and had become uncomfortable. Barry may have been somewhat homophobic and thus afraid that talking to Cliff in such an open way would make him appear gay, or at least effeminate. When Cliff told me about the incident, he said he now is wary of opening up to other men.

Five Steps to Create Meaningful Friendships
I told Cliff to consider using thinking about Five Steps to Create Meaningful Friendships. Here are the steps I outlined for Cliff:

Step 1 - Recognize and remind yourselfof the benefits of having friendship with another man. I told Cliff, "You have to want it."

Step 2 - Identify someone who might be a good friend, someone who might be willing to challenge traditional masculinity along with you.

Step 3 - Find a way to spend time with him. I told Cliff, "Some kind of activity is usually the easiest way to start."

Step 4 - Begin making honest, personal conversation with him when the time and context seem right. I pointed out to Cliff that his emotional venting at a cookout with other males within earshot perhaps was not the most conducive to personal conversation.

Step 5 - You might consider, if you feel appropriate, talking about your friendship with him at some point. If you've been successful in the first four steps, consider telling him that you value him and your time together.

Think of a male client you are treating who might benefit from the information that feelings can be expressed via verbal sharing, bodily manifestations, and outburst. Would it be beneficial to explore with your client the pros and cons of each? If the client feels verbal sharing to vent feelings would be beneficial, would a review of the above five steps in creating friendships be beneficial? As you know, many shame-based men are isolated and only limit their communication to emotionless, superficial "men's talk."

I stressed to Cliff that taking these steps would not be easy. Like many men, he would probably feel a little uncomfortable at various points, partly due to the homophobia that has been ingrained in men in our society. However, the satisfaction that comes from making a true friend may outweigh his anxieties.

In the next track, we will discuss creating empathy in relationships via the Fishbowl Technique.

Peer-Reviewed Journal Article References:
Barnes, D. M., & Meyer, I. H. (2012). Religious affiliation, internalized homophobia, and mental health in lesbians, gay men, and bisexuals. American Journal of Orthopsychiatry, 82(4), 505–515.

Kelly, E. L., Novaco, R. W., & Cauffman, E. (2019). Anger and depression among incarcerated male youth: Predictors of violent and nonviolent offending during adjustment to incarceration. Journal of Consulting and Clinical Psychology, 87(8), 693–705.

Klann, E. M., Wong, Y. J., & Rydell, R. J. (2018). Firm father figures: A moderated mediation model of perceived authoritarianism and the intergenerational transmission of gender messages from fathers to sons. Journal of Counseling Psychology, 65(4), 500–511. 

Mahalik, J. R., Sims, J. P., & Di Bianca, M. (2021). Men’s head and heart: Health beliefs mediating depression’s relationship to heart-healthy behaviors. Psychology of Men & Masculinities, 22(2), 422–426.

McDermott, R. C., Schwartz, J. P., Lindley, L. D., & Proietti, J. S. (2014). Exploring men’s homophobia: Associations with religious fundamentalism and gender role conflict domains. Psychology of Men & Masculinity, 15(2), 191–200. 

Starks, T. J., Doyle, K. M., Millar, B. M., & Parsons, J. T. (2017). Eriksonian intimacy development, relationship satisfaction, and depression in gay male couples. Psychology of Sexual Orientation and Gender Diversity, 4(2), 241–250.

Walch, S. E., Ngamake, S. T., Bovornusvakool, W., & Walker, S. V. (2016). Discrimination, internalized homophobia, and concealment in sexual minority physical and mental health. Psychology of Sexual Orientation and Gender Diversity, 3(1), 37–48. 

Online Continuing Education QUESTION 6
Your male client might benefit by reviewing three ways they can express their feelings. What are they? To select and enter your answer go to CE Test.

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